Improving Patient Engagement is a Top Priority for Most Providers

CDW Healthcare recently released a study on patient and provider perspectives on healthcare engagement. Here are some key findings from the report:

·         57% of patients say they have become more engaged with their healthcare during the past 2 years.

·         7 in 10 providers have noticed a change in their patients' level of engagement with their own healthcare.

·         35% of patients say they have noticed their providers become more engaged with them.

·         3 in 5 providers say improving patient engagement is a top priority at their organization.

·         58% of providers report improved engagement with patients in the past 2 years.

·         2 in 3 patients say they face challenges when trying to engage with their healthcare providers.

Source: CDW Healthcare, February 25, 2016

According to a recent survey, 33% of consumers currently use mobile health apps, up from 16% in 2014.

Source: "Consumers’ Use of Health Apps and Wearables Doubled in Past Two Years, Accenture Survey Finds," Accenture Press Release, March 3, 2016, https://newsroom.accenture.com/news/consumers-use-of-health-apps-and-wearables-doubled-in-past-two-years-accenture-survey-finds.htm   

According to a recent survey, here are the percentages of consumers and doctors who believe that virtual doctor visits provide the benefits listed below:

• lower costs (58% of consumers vs. 62% of doctors)
• convenience (52% of consumers vs. 80% of doctors
• timely access to care (42% of consumers vs. 49% of doctors)

Source: "Consumers’ Use of Health Apps and Wearables Doubled in Past Two Years, Accenture Survey Finds," Accenture Press Release, March 3, 2016, https://newsroom.accenture.com/news/consumers-use-of-health-apps-and-wearables-doubled-in-past-two-years-accenture-survey-finds.htm

Taxes and Health Care Coverage: Five Tips for Tax Filers

CMS BLOG

http://blog.cms.gov/2016/03/18/taxes-and-health-care-coverage-five-tips-for-tax-filers/

 

March 16, 2016

By: Kevin Counihan, CEO of the Health Insurance Marketplaces, Centers for Medicare and Medicaid Services

 

Taxes and Health Care Coverage: Five Tips for Tax Filers

 

Last year, millions of people purchased quality, affordable coverage through the Health Insurance Marketplace, and most benefitted from advance payments of the premium tax credit that lowered their monthly premiums. With the tax filing deadline a few weeks away, it’s a good time to remind everyone – both new and renewing consumers – about what they need to know when they file their taxes.

 

For those who returned to the Marketplace in 2015 to renew coverage or pick a different plan, the tax filing process is generally the same as last year. But, for the millions who signed up for Marketplace coverage in 2015 for the first time, the process may be a new one. By now, all Marketplace consumers should have received a statement in the mail from the Marketplace called a Form 1095-A. These statements include important information needed to complete and file a tax return.

 

Marketplace consumers who received advance payments of the premium tax credit are required to file a tax return to reconcile that financial assistance. This is similar to the reconciliation process for taxes withheld from wages during the year – consumers receive a larger or smaller refund depending on whether the appropriate taxes were withheld based on the tax filer’s actual income and other factors.

 

It’s extremely important that those who received advance payments of the premium tax credit reconcile these payments when they file their tax return. Individuals who do not do so will generally see their refunds delayed, and are not eligible to receive advance payments of the premium tax credit in future years.

 

Individuals with Marketplace or other types of health coverage may also have received additional forms called a Form 1095-B or 1095-C from their employer, insurance company, or the government program that provides their coverage, like Medicare or Medicaid. Taxpayers don’t need to attach this information to their return or wait to receive the form before filling their federal taxes, but should keep it in a safe place with other tax records.

 

An important reminder: Since most tax filers use a tax preparer or tax preparation software, most filers just need to answer questions when prompted.

 

We are here to help. Marketplace consumers having questions should contact the Marketplace Call Center (1-800-318-2596).  Additional resources and information for is also available at www.healthcare.gov/taxes or www.IRS.gov/aca.

 

Here’s summary of five helpful tips for both Marketplace consumers and other tax filers when it comes to filing taxes this year:

                                                                        

Five Tips for Tax Filers

1. Most people just need to check a box: The vast majority of tax filers have qualifying coverage (including employer coverage, Medicare, Medicaid, or other coverage) and will just need to check a box when they file their taxes to indicate that that everyone in their household had coverage for 2015. This year, many consumers will receive a new form called a Form 1095-B or a Form 1095-C in the mail from their employer, insurance company, or the government program that provides their coverage, like Medicare or Medicaid. Taxpayers don’t need to attach this information to their return or wait to receive the form before filling their taxes, but should keep it in a safe place with other tax records. For more information on all these forms, visit the IRS website at: https://www.irs.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals 
2.  
3. Marketplace consumers must file a tax return to reconcile any advance payment of the premium tax credit they received in order to maintain eligibility for future help: By now, all Marketplace consumers should have received a statement in the mail from the Marketplace called a Form 1095-A. These statements include important information needed to complete and file a tax return. It’s extremely important that those who received advance payments of the premium tax credit reconcile these payments when they file their tax return. Individuals who do not do so will generally see their refunds delayed, and are not eligible for advance payment of premium tax credits in future years.
4.  
5. The fee for not having coverage is increasing. For those who could afford health insurance and chose not to get coverage, the fee for not having minimum essential coverage in 2015 has increased to 2 percent of household income or $325 per person. The fee is pro-rated based on how many months a person is uninsured. The fee goes up again for 2016. If someone doesn’t have coverage or an exemption in the 2016 calendar year, but could afford coverage, the fee increases to $695 per person or 2.5% of income, whichever is higher. 

 

• Some people who didn’t have health coverage in 2015 will qualify for an exemption: While those who can afford health coverage but chose not to enroll generally have to pay a fee, some people who couldn’t afford coverage or met other conditions can receive an exemption. You can find out more information online from the Marketplace or IRS at https://www.healthcare.gov/health-coverage-exemptions/exemptions-from-the-fee or https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families.  

 

1. Help is available. If people have questions about Marketplace tax forms, qualifying for exemptions, or the fee, they should contact the Marketplace Call Center. The call center is open all day, every day at 1-800-318-2596. Additional resources and information for is also available at www.healthcare.gov/taxes or www.IRS.gov/aca

COMPETITIVE BIDDING PROGRAM CONTINUES TO MAINTAIN ACCESS AND QUALITY WHILE SAVING MEDICARE BILLIONS

FACT SHEET

 

FOR IMMEDIATE RELEASE

March 15, 2016

 

Contact: CMS Media Relations

(202) 690-6145 | CMS Media Inquiries

 

 

COMPETITIVE BIDDING PROGRAM CONTINUES TO MAINTAIN ACCESS AND QUALITY WHILE SAVING MEDICARE BILLIONS

 

Overview

 

The Centers for Medicare & Medicaid Services (CMS) today announced the new single payment amounts and began sending contract offers to successful bidders for Medicare’s Round 2 Recompete and the national mail-order recompete Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. These new payment amounts and contracts go into effect on July 1, 2016. This program has been an essential tool to help Medicare set appropriate payment rates for DMEPOS items and save money for beneficiaries and taxpayers while ensuring access to quality items.

 

Prior to the DMEPOS Competitive Bidding Program, Medicare paid for these DMEPOS items using a fee schedule that is generally based on historic supplier charges from the 1980s. Numerous studies from the Department of Health and Human Services Office of Inspector General and the Government Accountability Office have shown these fee schedule prices to be excessive, and taxpayers and Medicare beneficiaries bear the burden of these excessive payments.   

 

Under the Competitive Bidding Program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas.  After the first two years of Round 2 and the national mail-order programs (July 1, 2013-June 30 2015), Medicare has saved approximately $3.6 billion while health monitoring data indicate that its implementation is going smoothly with few inquiries or complaints and no changes to beneficiary health outcomes.   

 

The Round 2 and national mail-order program contract periods expire on June 30, 2016. Round 2 Recompete and the national mail-order recompete contracts will become effective on July 1, 2016 through December 31, 2018. The national mail-order recompete for diabetes testing supplies will be implemented at the same time as Round 2 Recompete and will include all parts of the United States, including the 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa. 

 

Background

 

The Medicare DMEPOS Competitive Bidding Program was established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“Medicare Modernization Act” or “MMA”) after the conclusion of successful demonstration projects. Under the MMA, the DMEPOS Competitive Bidding Program was to be phased in so that competition under the program would first occur in 10 Metropolitan Statistical Areas (MSAs) in 2007. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) temporarily delayed the program in 2008 and made certain limited changes. In accordance with MIPPA, CMS successfully conducted the supplier competition again in nine areas in 2009, referring to it as the Round 1 Rebid.

 

MIPPA also delayed the competition for Round 2 from 2009 to 2011 and authorized national mail-order competitions after 2010.  The Affordable Care Act of 2010 (ACA) expanded the number of Round 2 MSAs from 70 to 91 and specified that all areas of the country be subject to either DMEPOS competitive bidding or payment rate adjustments using competitively bid rates by January 1, 2016.

 

Competitive bidding contracts and pricing have been in place in Round 1 areas since January 1, 2011 with the current Round 1 Recompete contracts and prices being in place since January 1, 2014. CMS is currently evaluating bids received as part of the Round 1 2017 competition, which is scheduled to be implemented on January 1, 2017.

 

Round 2 and the national mail-order program for diabetes testing supplies was implemented on July 1, 2013. The supplier bidding period for Round 2 Recompete and the national mail-order recompete for diabetes testing supplies concluded on March 26, 2015. 

Contract Award Process 

The DMEPOS Competitive Bidding Program’s bid evaluation process ensures that there will be a sufficient number of suppliers to meet the needs of the beneficiaries living in a competitive bidding area. The new single payment amounts resulting from the competition replace the previous single payment amounts for the bid items in these areas. Small suppliers, those with gross revenues of $3.5 million or less, make up about 56 percent of the suppliers that will be offered contracts for Round 2 Recompete.  22 percent of national mail-order contract offers are going to small suppliers.  All suppliers that are offered contracts went through a thorough vetting process and are accredited and meet financial and applicable licensing standards. 

 

CMS will now begin offering contracts to winning bidders. 12,181 contract offers will be made to 637 Round 2 Recompete bidders.  Of these offers, 93 percent are to bidders who currently furnish items in the awarded area or within the product category. The winning suppliers have 2,341 locations to serve Medicare beneficiaries in the competitive bidding areas. CMS will offer 9 contracts for the national mail-order program.  CMS expects to complete the contracting process in time to announce the contract suppliers in the spring of 2016.  Bidders that are not offered contracts will be notified of the reasons why they did not qualify for the program when the contracting process is complete. Suppliers that are not contract suppliers for this round of the DMEPOS Competitive Bidding Program may bid in future rounds, unless they are precluded from participation in the program. 

Additional information on the distribution of contract offers is available at the following Web site: www.dmecompetitivebid.com. 

REAL-TIME MONITORING  

Importantly, the program has maintained beneficiary access to quality products from accredited suppliers in all competitive bidding areas. Extensive real-time monitoring data have shown successful implementation with very few beneficiary complaints and no negative impact on beneficiary health status based on measures such as hospitalizations, length of hospital stay, and number of emergency room visits compared to non-competitive bidding areas.  In addition to our real-time claims monitoring, CMS also requested feedback from beneficiaries through consumer satisfaction surveys conducted before and after the rollout of the program. CMS provides local, on-the-ground presence in each competitive bidding area through the CMS regional offices, local liaisons, and a Competitive Acquisition Ombudsman who closely monitors and responds to inquiries and complaints about the application of the program from beneficiaries who use items of DMEPOS under the program, contract suppliers who provide these items, and other stakeholders. There is also a formal complaint process for beneficiaries, caregivers, providers and suppliers to use for reporting concerns about contract suppliers or other competitive bidding implementation issues.  In addition, contract suppliers are responsible for submitting reports identifying the brands of products they furnish, which is used to inform beneficiaries, caregivers, and referral agents.  CMS will continue to employ the same aggressive program monitoring for future rounds. 

ROUND 2 RECOMPETE PRODUCT CATEGORIES AND AREAS

 

The Round 2 Recompete product categories are:

 

• Enteral Nutrients , Equipment, and  Supplies
• General Home Equipment and Related Supplies and Accessories
• includes hospital beds and related accessories, group 1 and 2 support surfaces, commode chairs, patient lifts, and seat lifts
• Nebulizers and Related Supplies
• Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories
• Respiratory Equipment and Related Supplies and Accessories
• includes oxygen, oxygen equipment, and supplies; continuous positive airway pressure (CPAP) devices and respiratory assist devices (RADs) and related supplies and accessories
• Standard Mobility Equipment and Related Accessories
• includes walkers, standard power and manual wheelchairs, scooters, and related accessories
• Transcutaneous Electrical Nerve Stimulation (TENS) Devices and Supplies

 

For a list of the specific items in each product category, or for a list of the areas included in Round 2 Recompete, visit the Competitive Bidding Implementation Contractor website at www.dmecompetitivebid.com. 

 

Round 2 Recompete and National Mail-Order recompete Timeline of Events

 

March 15, 2016          CMS announces new payment rates for Round 2 Recompete and the national mail-order recompete and begins contracting process with winning suppliers

 

Spring 2016                CMS announces the Medicare contract suppliers for Round 2 Recompete and the national mail-order recompete; intensifies supplier, referral agent, and beneficiary education program

 

July 1, 2016                Implementation of Medicare DMEPOS Competitive Bidding Program Round 2 Recompete and national mail-order recompete contracts and prices

 

ADDITIONAL INFORMATION

For additional information about the Medicare DMEPOS Competitive Bidding Program, please visit:  http://www.cms.hhs.gov/DMEPOSCompetitiveBid/.

Registration is now open for the “Assisting Consumers with Complex Situations” webinar on Wednesday, March 30, from 1:00 PM to 2:30 PM Eastern Time.

CMS subject matter experts (SMEs) will share how you can help consumers manage commonly seen, but complex, health coverage situations. The webinar will cover:

• Determining if a consumer’s household is a multi-tax household and, if so, how to group family members for enrollment in qualified health plans (QHPs)
• Enrolling family members for reasons of preference in different QHPs
• Applying for, allocating, and reconciling advance payments of the premium tax credit (APTC) in these complex situations
• Making decisions when consumers have eligibility options (i.e., QHP coverage versus other coverage such as Medicare, Medicaid, or the Children’s Health Insurance Program)
• Transitioning from an QHP to other coverageIn addition to presenting relevant policy and step-by-step processes, SMEs will apply this guidance to a number of “real life” scenarios, and take your questions via the webinar’s online chat feature. The webinar will also offer links to resources on these topics that you can access anytime. 

To register for the webinar, please log in to www.REGTAP.info. If you have questions on the webinar registration process, visit the new “Upcoming Agent and Broker Webinars” section of the Agents and Brokers Resources webpage for more information.

CMS Releases Interactive Mapping Medicare Disparities Tool

CMS NEWS

 

FOR IMMEDIATE RELEASE

March 17, 2016

 

Contact: CMS Media Relations

(202) 690-6145 | CMS Media Inquiries

 

 

CMS Releases Interactive Mapping Medicare Disparities Tool

Today, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location. Understanding geographic differences in disparities is important to informing policy decisions and efficiently targeting populations and geographies for interventions.

“Our commitment to health equity begins with properly measuring the care people get and having an honest dialogue on how and where we need to improve,” said CMS Acting Administrator Andy Slavitt. “Today’s tool aims to make it harder for disparities to go unaddressed.”

Racial and ethnic minorities experience disproportionately high rates of chronic diseases, and are more likely to experience difficulty accessing high quality of care than other individuals. The identification of areas with large differences in the proportions of Medicare beneficiaries with chronic diseases is an important step for informing and planning health equity activities and initiatives. The Mapping Medicare Disparities Tool features:

• A dynamic interface with data on the prevalence of 18 chronic conditions, end stage renal disease, or a disability; Medicare spending, hospital and emergency department (ED) utilization, preventable hospitalizations, readmissions, and mortality rates.
• The ability to sort by state or county of residence, sex, age, dual-eligibility for Medicare and Medicaid, and race and ethnicity.
• Built-in benchmarking features to investigate disparities within counties and across racial and ethnic groups, and within racial and ethnic groups across counties.

ls under Priority Area 1 of

“It’s not enough to improve average health care quality in the U.S.,” said CMS OMH Director Cara James. “As the CMS Equity Plan lays out, we must identify gaps in quality of care at all levels of the health care system to address disparities. We are excited to share this new tool, which allows us to pinpoint disparities in health care outcomes by population and condition.”

The MMD Tool was developed in collaboration with KPMG LLC and NORC at the University of Chicago as part of the CMS Equity Plan for Improving Quality in Medicare. The plan provides a framework for advancing health equity by improving the quality of care provided to minority and other underserved Medicare beneficiaries. MMD Tool

To access the MMD tool, visit https://www.cms.gov/About-CMS/Agency-Information/OMH/OMH-Mapping-Medicare-Disparities.html

To learn more about how to use the tool and its data sources, see the MMD Tool Overview. Further details are available in the MMD Tool Frequently Asked Questions (FAQ), the Quick Start Guide, and the MMD Tool Technical Documentation.

Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) was established as a result of the Patient Protection and Affordable Care Act (ACA) and  works to eliminate health disparities and improve the health of all minority populations, including racial and ethnic minorities, people with disabilities, members of the LGBT community, and rural populations.